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M09.03.022 Ethical situations
Understanding how to navigate ethical dilemmas is crucial for healthcare professionals. Below are various ethical situations along with the appropriate responses that can guide medical practitioners in making informed decisions while prioritizing patient safety and care.
Ethical Situations and Appropriate Responses
| Situation | Appropriate Response |
|---|---|
| A patient requires a treatment not covered by insurance | Never limit or deny care based on cost. Discuss all treatment options with the patient, including those not covered by insurance. |
| A 7-year-old boy feels responsible for his sister’s death | Provide a clear and direct explanation of death. Avoid euphemisms and reassurances that he is not to blame. Normalize his feelings and fears. Encourage healthy coping behaviors, such as remembering his sister in his own way. |
| A Patient is a victim of intimate partner violence | Assess the patient’s safety and if they have an emergency plan. Do not pressure them to leave their partner or disclose incidents to authorities unless mandated by state law. |
| A Patient wants to try alternative or holistic medicine | Explore the reasons for the patient’s interest in alternative treatments in a supportive manner. Inform them about the known benefits, risks, adverse effects, contraindications, and medication interactions. |
| Physician colleague presents to work-impaired | Report the impaired colleague to local supervisory personnel as they pose a threat to patient safety. If no action is taken, notify the state licensing board. |
| Patient determined to suffer brain death; family insists on life support | Explain gently to the family that brain death is equivalent to death, and movement is a reflex, not voluntary. Refer the case to the ethics board regarding the futility of care and potential withdrawal of life support. |
| Pharmaceutical company offers sponsorship for advertising | Decline the offer to avoid conflicts of interest. According to the AMA Code of Ethics, gifts and sponsorships should generally be refused unless they directly benefit patients, are of minimal value, fund medical education, or are distributed based on independent criteria. |
| Patient requests a procedure against personal or religious beliefs | Provide unbiased information to help the patient make an informed decision. Explain that you do not perform the procedure but offer a referral to another physician who can. |
| Mother and 15-year-old daughter are unresponsive; father denies transfusion based on religion | Transfuse the daughter, as emergent care cannot be refused for minors based on the parent’s religious beliefs. Do not transfuse the mother if the healthcare proxy has refused based on known preferences. |
| A Child presents with injuries inconsistent with the parental story | Contact child protective services immediately to ensure the child’s safety. Physicians are mandated by law to report any reasonable suspicion of child abuse or endangerment. |
Points to Remember
- Ethical dilemmas often require balancing patient autonomy with professional responsibilities.
- Always prioritize patient safety and well-being.
- Open communication with patients and families is vital for ethical decision-making.
- Familiarize yourself with legal obligations regarding patient care and reporting.
References
- American Medical Association (AMA) Code of Medical Ethics. AMA Ethics
- Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
- Gillon, R. (1994). Medical ethics: Four principles plus attention to scope. BMJ, 309(6948), 184. doi:10.1136/bmj.309.6948.184.